Ergonomía en endoscopia: visualización de una herramienta indispensable en endoscopia / Ergonomics in endoscopy, visualization of an indispensable tool in endoscopy

Endoscopic ergonomics, the study of the endoscopist's interaction with their work environment, aims to adapt tools and actions to their physical and psychological characteristics. Musculoskeletal disorders (MSDs) are highly prevalent among endoscopists (39-89%), mainly due to repetitive movements. This issue is exacerbated by pro- cedures such as EUS, ERCP, and third space endoscopy, which demand more time and instrument use. Despite knowing the risk factors, preventive and modification strategies are scarce in endoscopic centers and the industry. This is concerning, given the impact on health, work disability, and the functioning of endoscopy services. It is crucial to raise awareness and educate on this topic to improve the quality of life of endoscopists and the efficiency of services

La ergonomía endoscópica, que estudia la interacción del endoscopista con su entorno laboral, busca adaptar herramientas y acciones a sus características físicas y psicológicas. Los trastornos musculoesqueléticos (TME) son altamente prevalentes en endoscopistas (39-89%), principalmente debido a movimientos repetitivos. Esta problemática se intensifica con procedimientos como la EUS, ERCP y la endoscopia de tercer espacio, que de- mandan más tiempo y uso de instrumentos. A pesar de conocer los factores de riesgo, las estrategias preventivas y de modificación son escasas en centros endoscópicos y en la industria. Esto es preocupante, dado el impacto en la salud, la incapacidad laboral y el funcionamiento de los servicios de endoscopia. Es crucial visibilizar y educar sobre este tema para mejorar la calidad de vida de los endoscopistas y la eficiencia de los servicios

Autocuidado digital en el manejo de los trastornos musculoesqueléticos de columna: revisión sistemática y metanálisis / Digital self-care in the management of spine musculoskeletal disorders: A systematic review and meta-analysis / Autocuidado digital no manejo de distúrbios musculoesqueléticos de coluna: revisão sistemática e metanálise

Objetivo: analizar la efectividad del autocuidado digital en el manejo del dolor y la discapacidad funcional en personas con trastornos musculoesqueléticos espinales. Método: revisión sistemática de la literatura, desarrollada con la checklist PRISMA, de ensayos clínicos aleatorizados sobre personas con trastornos musculoesqueléticos de columna e intervenciones digitales a las que se accede por computadora, smartphones u otro dispositivo portátil. Bases de datos consultadas: National Library of Medicine, Excerpta Médica dataBASE, SciVerse Scopus, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Science Citation Indexes, Cummulative Index to Nursing and Allied Health Literature y Physiotherapy Evidence Database. Síntesis de resultados descriptiva y por metanálisis (modelo de efectos fijos) realizada con el software Review Manager. Calidad metodológica evaluada mediante la escala Physiotherapy Evidence Database. Resultados: se seleccionaron 25 ensayos (5142 participantes) que mostraron mejoras estadísticamente significativas (p<0,05) del 54% (12/22) en los niveles de dolor y del 47% (10/21) en la discapacidad funcional en el grupo intervención. Los metanálisis mostraron efectos moderados sobre la intensidad del dolor y efectos pequeños sobre la discapacidad funcional. Predominaron los estudios de calidad media. Conclusión: las intervenciones de atención digital demostraron resultados beneficiosos para la intensidad del dolor y la discapacidad funcional, principalmente para el dolor lumbar crónico. Se ha demostrado que la atención digital es promisoria para favorecer el automanejo de las afecciones musculoesqueléticas de columna. Registro PROSPERO CRD42021282102.

Objective: to analyze the effectiveness of digital self-care in the management of pain and functional disability among people with spine musculoskeletal disorders. Method: a systematic literature review, developed with the PRISMA checklist, of randomized clinical trials of people with spine musculoskeletal disorders and digital interventions accessed by means of computers, smartphones or other portable devices. Databases researched: National Library of Medicine, Excerpta Médica dataBASE, SciVerse Scopus, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Science Citation Indexes, Cumulative Index to Nursing and Allied Health Literature and Physiotherapy Evidence Database. The descriptive synthesis of the results and by means of meta-analyses (fixed-effects model) was performed with the Review Manager software. The methodological quality was evaluated with the Physiotherapy Evidence Database scale. Results: a total of 25 trials were selected (5,142 participants), which showed statistically significant improvements (p <0.05) in 54% (12/22) in the pain levels and 47% (10/21) in functional disability in the Intervention Group. The meta-analyses showed moderate effects on pain intensity and small effects on functional disability. There was a predominance of medium quality studies. Conclusion: the digital care interventions showed a beneficial result in pain intensity and in functional disability, mainly for chronic low back pain. Digital care emerges as promising to support self-management of the spine musculoskeletal conditions. PROSPERO registry number CRD42021282102.

Objetivo: analisar a efetividade do autocuidado digital no manejo da dor e incapacidade funcional em pessoas com distúrbios musculoesqueléticos de coluna. Método: revisão sistemática da literatura, desenvolvida com o checklist PRISMA, de ensaios clínicos randomizados de pessoas com distúrbios musculoesqueléticos de coluna e intervenções digitais acessadas por computador, smartphones ou outro dispositivo portátil. Bases pesquisadas: National Library of Medicine, Excerpta Médica dataBASE, SciVerse Scopus, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Science Citation Indexes, Cummulative Index to Nursing and Allied Health Literature e Physiotherapy Evidence Database. Síntese dos resultados descritiva e por metanálises (modelo de efeitos fixos) com o software Review Manager. Qualidade metodológica avaliada pela escala Physiotherapy Evidence Database. Resultados: selecionaram-se 25 ensaios (5142 participantes) que revelaram melhoras estatisticamente significativas (p<0,05) em 54% (12/22) nos níveis de dor e 47% (10/21) na incapacidade funcional no grupo intervenção. As metanálises mostraram efeitos moderados na intensidade da dor e pequenos na incapacidade funcional. Houve predominância de estudos de média qualidade. Conclusão: intervenções de cuidados digitais mostraram resultado benéfico na intensidade da dor e na incapacidade funcional principalmente para dor lombar crônica. Evidenciam-se os cuidados digitais como promissores para apoiar o autogerenciamento das condições musculoesqueléticas de coluna. Registro PROSPERO CRD42021282102.

Intervenciones ergonómicas y su impacto en la profesión odontológica / Ergonomic interventions and their impact on the dental profession / Intervenções ergonômicas e seu impacto sobre a profissão odontológica

Introducción: los desórdenes músculoesqueletales tienen una alta prevalencia en la población general y en particular, en el área salud, los profesionales de la odontología representan una población altamente vulnerable, debido a características particulares del ejercicio de su profesión. Es creciente el estudio de diferentes intervenciones ergonómicas y el impacto que estas pueden tener sobre la reducción de la sintomatología muscular y en el desarrollo y/o la perpetuación de estos cuadros disfuncionales. Materiales y método: se realizó una revisión, de tipo narrativa, entre los meses de abril de 2022 y agosto de 2022. Se consultaron base de datos tales como MedLine/PubMed y Scielo, incluyendo artículos publicados en los últimos diez años. Resultados: se obtuvieron un total de 71 artículos, de los cuales, se excluyeron 30 trabajos, resultando en 41 los artículos incluidos en la presente síntesis cualitativa. Conclusiones: las intervenciones ergonómicas están dirigidas básicamente, a cambios en los ambientes de trabajo de los profesionales y/o a la implementación de programas que tienen como objetivo instruir y concientizar a los profesionales sobre criterios ergonómicos para su incorporación en el desempeño de su trabajo. Ambos enfoques intervencionistas, han sido evaluados con herramientas validadas de autopercepción, exámenes clínicos y evaluaciones instrumentales. Las estrategias que focalizan el problema, en los espacios de trabajo, y aquellas que, incluyen educación y formación en ergonomía, disminuyen el impacto de los desórdenes músculoesqueletales en esta población. Estas últimas, tienen la potencialidad de provocar cambios en los hábitos de los profesionales, con conductas que se mantienen a mediano plazo.

Introduction: musculoskeletal disorders have a high prevalence in the general population and in particular, in the health area, dental professionals represent a highly vulnerable population, due to the particular characteristics of the practice of their profession. The study of different ergonomic interventions and the impact they can have on the reduction of muscular symptomatology and on the development and/or perpetuation of these dysfunctional conditions is growing. Method: a narrative review was carried out between April 2022 and August 2022. Databases such as MedLine/PubMed and Scielo were consulted, including articles published in the last ten years. Results: a total of 71 articles were obtained, of which 30 were excluded, resulting in 41 articles included in this qualitative synthesis. Conclusions: ergonomic interventions are basically aimed at changes in the working environments of professionals and/or the implementation of programs aimed at instructing and making professionals aware of ergonomic criteria for their incorporation in their work performance. Both interventionist approaches have been evaluated with validated self-perception tools, clinical examinations and instrumental evaluations. Strategies that focus the problem in the workplace and those that include education and training in ergonomics reduce the impact of musculoskeletal disorders in this population. The latter have the potential to provoke changes in the habits of professionals, with behaviors that are maintained in the medium term.

Introdução: os distúrbios músculo-esqueléticos são altamente prevalentes na população em geral e, em particular, na área da saúde, os profissionais da odontologia representam uma população altamente vulnerável, devido às características particulares do exercício de sua profissão. O estudo de diferentes intervenções ergonômicas e o impacto que elas podem ter na redução dos sintomas musculares e no desenvolvimento e/ou perpetuação dessas condições disfuncionais está crescendo. Materiais e métodos: foi realizada uma revisão narrativa entre abril de 2022 e agosto de 2022. Bases de dados como MedLine/PubMed e Scielo foram consultadas, incluindo artigos publicados nos últimos dez anos. Resultados: foram obtidos um total de 71 artigos, dos quais 30 foram excluídos, resultando em 41 artigos incluídos nesta síntese qualitativa. Conclusões: as intervenções ergonômicas visam basicamente a mudanças nos ambientes de trabalho dos profissionais e/ou a implementação de programas que visam instruir e conscientizar os profissionais sobre critérios ergonômicos para sua incorporação em seu trabalho. Ambas as abordagens intervencionistas foram avaliadas com ferramentas validadas de autopercepção, exames clínicos e avaliações instrumentais. As estratégias que visam o problema no local de trabalho e aquelas que incluem educação e treinamento em ergonomia reduzem o impacto dos distúrbios músculo-esqueléticos nesta população. Estes últimos têm o potencial de provocar mudanças nos hábitos dos profissionais, com comportamentos que são mantidos a médio prazo.

Optic neuromyelitis in relation with juvenile idiopathic arthritis: A case report

Optic neuromyelitis (ONM), also called neuromyelitis optica spectrum (Neuromyelitis Optica Spectrum Disorders, NMOSD) is recognized as an inflammatory autoimmune demyelinating disease of the central nervous system, mediated by autoantibodies against the aquaporin-4 receptor (AQP4-IgG). It predominantly affects the optic nerves and the spinal cord.1-3 It is known that patients with immune disorders are more likely to present other autoimmune diseases, but the relation between juvenile idiopathic arthritis and ONM has not been completely described.5 In this paper, we report a case of a patient with juvenile idiopathic arthritis, presenting with a rapidly progressive neurological condition, who is treated with biological drugs.1-4

La neuromielitis óptica (NMO), también llamada espectro de la neuromielitis óptica (neuromyelitis optica spectrum disorders) se reconoce como una enfermedad inflamatoria, autoinmune, desmielinizante del sistema nervioso central, mediada por autoanticuerpos contra el receptor de acuaporina 4 (AQP4-IgG) que afecta predominantemente a los nervios ópticos y la médula espinal1-3. Es conocido que los pacientes con trastornos inmunitarios tienen más probabilidades de presentar otras enfermedades autoinmunes; sin embargo, no está completamente descrita la asociación entre artritis idiopática juvenil y NMO5. En este escrito se reporta el caso de una paciente que cursa con artritis idiopática juvenil, inició con compromiso neurológico rápidamente progresivo, y es tratada con medicamentos biológicos1-4.

Modifications in self-care, quality of life and therapeutic adherence in patients with rheumatoid arthritis during the SARS-CoV-2 pandemic treated by telehealth

Introduction: Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation, causing pain and stiffness in the joints. SARS-CoV-2 increases the clinical vulnerability of the population with RA and has led to the implementation and/or development of telemedicine. Objective: To describe changes in level of therapeutic adherence, quality of life and capacity for self-care agency, during the follow-up period of a group of patients linked to a non-face-to-face multidisciplinary consultation model during the SARS-CoV-2 pandemic. Methodology: Descriptive cohort study (July to October 2020). Description of the level of therapeutic adherence (Morisky Green Test), quality of life (EuroQOL-5-Dimensions-3-Level-version) and self-care capacity (ASA-R Scale) in the context of a telehealth model. A univariate and bivariate analysis was performed (Stata Software, Considered p-value <0.05). Results: Of 71 patients treated under the telehealth model, 85.9% were women, the age range was between 33 and 86 years with a median of 63. The most prevalent comorbidity was arterial hypertension (35.2%). Quality of life did not change during follow-up nor did adherence to treatment, apart from in one item [the patients did not stop taking the medication when they were well (p = 0.029)]. In self-care capacity, there were significant improvements in five dimensions (p < 0.05), without significant differences in the global score. Conclusion: Patients with RA evaluated in the context of telehealth in a period of pandemic did not present significant changes in quality of life, adherence to treatment, or capacity for self-care, and remained close to baseline values when they attended a traditional face-to-face assessment.

INTRODUCCIÓN: La artritis reumatoide (AR) es una enfermedad autoinmune caracterizada por una inflamación crónica que produce dolor y rigidez articular. El SARS-CoV-2 aumenta la vulnerabilidad clínica en pacientes con AR, lo que ha conllevado la implementación o el desarrollo de la telesalud. OBJETIVO: Describir los cambios en el nivel de adherencia terapéutica, la calidad de vida y la capacidad de autocuidado durante el periodo de seguimiento, en un grupo de pacientes con AR vinculados con un modelo de consulta multidisciplinar no presencial, en el curso de la pandemia por SARS-CoV-2. METODOLOGÍA: Estudio de cohorte descriptiva (julio a octubre del 2020). Descripción del nivel de adherencia terapéutica (TEST MORISKY GREEN), calidad de vida (EUROQOL-5-DIMENSIONS-3-LEVEL-VERSION) y capacidad de autocuidado (Escala ASA-R) en el contexto de un modelo de telesalud. Se realizó análisis univariado y bivariado (SOFTWARE Stata®, valor de p considerado <0,05). RESULTADOS: De 71 pacientes atendidos en modalidad de telesalud, el 85,9% fueron mujeres, la mediana de la edad fue de 63 (33-86) anos. La comorbilidad más prevalente fue la hipertensión (35,2%). La calidad de vida no tuvo cambios durante el seguimiento, al igual que la adherencia al tratamiento, excepto en uno de los ítems (los pacientes no dejaron de tomar la medicación cuando se encontraban bien; p = 0,029). En la capacidad de autocuidado hubo mejoras significativas en 5 dimensiones (p < 0,05), sin diferencias significativas en el puntaje global. CONCLUSIÓN: Los pacientes con AR evaluados en el contexto de la telesalud, en un periodo de pandemia, no presentaron cambios significativos en la calidad de vida, la adherencia al tratamiento y la capacidad de autocuidado; se mantuvieron en niveles similares a los valores basales cuando asistían a valoración tradicional presencial.

Comorbidity of sleep apnoea syndrome in patients with fibromyalgia in a sleep clinic

Introduction: Fibromyalgia syndrome (FMS) is characterized by chronic musculoskeletal pain, fatigue, and the sense of waking unrefreshed. Obstructive sleep apnoea syndrome (OSAS) and FMS have symptoms in common and the association of OSAS in these patients could confuse the diagnosis and worsen the severity and prognosis of FMS. The objective of this study was to establish the presence of OSAS in patients with FMS and sleep complaints in a sleep clinic. Methods: A cross-sectional study was conducted in patients aged 18 and above with FMS who were referred by rheumatology to a sleep clinic to confirm OSAS with polysomnography from 2015 to 2018. Descriptive statistics tools were applied. Results: Polysomnographic investigations were performed in 51 patients with FMS. OSAS was detected in 82% of patients. The mean age was 65 years. Of the patients studied, 82% were women and 78% of them had OSAS. All the male patients with FM had OSAS. Of the patients, 27.5% were normal weight and 45% were overweight. Of the patients, 23% had severe OSAS, 31% moderate and 45% mild. Conclusion: We found a high frequency of OSAS in this group of FMS patients. Since the 2 diseases share symptoms, it is interesting to delve deeper into the investigation of common pathophysiological mechanisms. The coexistence of the 2 pathologies poses diagnostic and therapeutic challenges that implies the need for further study at local level.

Introducción: La fibromialgia (FM) se caracteriza por dolor crónico, cansancio y sueno no reparador. El síndrome de apnea hipopnea obstructiva del sueño (SAHOS) tiene síntomas en común con la FM y su presencia puede confundir el diagnóstico y empeorar la gravedad y el pronóstico de la FM. El objetivo de este estudio fue establecer la presencia de SAHOS en pacientes con FM y alteraciones del sueño en una clínica de sueño. Métodos: Estudio observacional, de corte transversal, en pacientes mayores de 18 arios con FM remitidos por Reumatología a una clínica de sueño para confirmar SAHOS por medio de polisomnografía, entre el 2015 y el 2018. Se aplicaron herramientas de estadística descriptiva. Resultados: Se realizó polisomnografía completa a 51 pacientes con FM y se confirmó SAHOS en el 82%. La edad media fue de 65 años. El 82% de los pacientes estudiados fueron mujeres y, de estas, el 78% tuvo SAHOS. Al 100% de los hombres con FM se les diagnosticó SAHOS. El 27,5% tuvo un peso normal y el 45% sobrepeso. El 23% de los pacientes tuvo SAHOS grave, el 31% moderado y el 45% leve. Conclusiones: Encontramos una alta frecuencia de SAHOS en este grupo de pacientes con FM. Las 2 enfermedades comparten síntomas, por lo que es interesante profundizar más en la investigación de mecanismos fisiopatológicos comunes. La coexistencia de las 2 patologías plantea retos diagnósticos y terapéuticos que vislumbran la necesidad de estudios más profundos a escala local.

Trastornos musculoesqueléticos y dolor asociados a exigencias laborales en pescadores de mediana escala de Yucalpetén, Yucatán, México / Musculoskeletal disorders and pain associated with demands work in medium-scale fishermen from Yucalpetén, Yucatán, México

Los pescadores suelen ejercer su actividad en altamar en condiciones precarias y sometidos a diversas exigencias de trabajo que con el tiempo derivan en diversos daños a la salud entre los que se encuentran los trastornos musculoesqueléticos (TME), los cuales se reportan a nivel mundial, como la principal causa de discapacidad y jubilaciones anticipadas. Objetivo: Identificar las exigencias laborales, daños musculoesqueléticos y dolor asociados a la actividad laboral de los pescadores en Progreso, Yucatán, México, con la intención de visibilizar y generar evidencia empírica en materia laboral en trabajadores de este sector, ante la carencia de información, pese a que es una de las actividades más peligrosas en el mundo. Materiales y Métodos: Estudio descriptivo, analítico y transversal. Participaron 134 pescadores a los que se les aplicó una encuesta individual, previo consentimiento informado. Las variables se analizaron y controlaron en el programa JMP versión 15, con un nivel de significancia menor a p<0.05 y un intervalo de confianza del 95%. Resultados: Las principales exigencias que se señalan son posturas forzadas y movimientos repetitivos. Las zonas del cuerpo más afectadas, espalda, cintura y caderas (44%), miembros superiores (40%), inferiores (30%) y cuello (17%). Conclusión: Los resultados evidencian la relación de los trastornos musculoesqueléticos con las exigencias laborales. Se destaca la presencia de dolor en espalda baja, hombros y cuello. por lo que es necesario implementar programas de capacitación y evaluación ergonómica sobre posturas y cargas, así como programas de rehabilitación a corto plazo(AU)

Fishermen usually carry out their activity on the high seas in precarious conditions and subject to various work demands that over time lead to various health damages, among which are musculoskeletal disorders (MSDs), which are reported worldwide, such as the leading cause of disability and early retirement. Objective: Identify labor demands, musculoskeletal damages problems and pain associated with the work activity of fishermen in Progress, Yucatán, México, with the intention of making visible and generating empirical evidence on labor matters in workers in this sector, given the lack of information, despite the fact it is one of the most dangerous activities in the world. Materials y Methods: Descriptive, analytical and cross-sectional study. 134 fishermen participated to whom an individual survey was applied, with prior informed consent. The variables were analyzed and controlled in the program JMP version 15, with a significance level of less than p<0.05 and a 95% confidence Interval. Results: The main demands that are pointed out are forced postures and repetitive movements. The most affected areas of the body: back, waist and hips (44%), upper limbs (40%) lower limbs (30%) and neck (17%). The results show the relationship between musculoskeletal disorders with work demands. Conclusions: The presence of pain in the lower back, shoulders and neck stands out. Therefore, it is necessary to implement ergonomic training and evaluation programs on postures and loads, as well as short-term rehabilitation programs(AU)

Clinical and demographic characterization of the population with osteoporosis in two reference medical centres in Colombia / Caracterización clínica y demográfica de la población con osteoporosis en 2 centros médicos de referencia en Colombia

ABSTRACT Introduction: Osteoporosis is a public health problem. However, there is still a lack of data in Colombia on the characteristics of patients with osteoporosis. Objectives: This study aims to characterize the population with osteoporosis without previous diagnosis. Materials and methods: Observational, retrospective, descriptive study in patients with osteoporosis. Patients diagnosed between 2014 and 2017 were included. The information was obtained from the patient medical records and the densitometry results. Results: Most (92.2%) of the patients came from Medellín, and the rest from Cali. The mean age of the population was 65.1 years (SD: 9.97). As regards the history of fracture, it was reported that 12.0% had suffered from vertebral fractures, 2.3% had a history of fracture in the distal radius, 2.8% in the femoral neck, and 1.4% had had femoral shaft fracture. Bone densitometry showed a mean T-score of -2.90 in the femoral neck; -3.02 in total hip; -3.03 in the lumbar spine, and -3.42 in the 33% radius. In the 602 patients who had a control bone densitometry, an average BMD gain was seen in all the evaluated regions. Conclusions: The present study has enabled the characterizing of patients from 2 Colombian cities with a diagnosis of osteoporosis. The 2 most frequently reported locations for the diagnosis of osteoporosis were lumbar spine and femoral neck. An average BMD gain was also observed.

RESUMEN Introducción: La osteoporosis es un problema de salud pública, sin embargo, en Colombia en la actualidad faltan datos sobre las características de los pacientes con esta enfermedad. Objetivos: Este estudio pretende caracterizar la población con osteoporosis sin diagnóstico previo. Materiales y métodos: Estudio observacional, retrospectivo, descriptivo en pacientes con osteoporosis. Incluyó a pacientes diagnosticados entre el 2014 y el 2017. La información fue obtenida a partir de las historias clínicas de los pacientes y el resultado de la densitometría. Resultados: El 92,2% de los pacientes provenía de Medellín y los restantes de Cali. La edad promedio ± desviación estándar de la población fue 65,1 ± 9,97 arios. En cuanto al antecedente de fractura, se reportó que el 12,0% había presentado fracturas vertebrales, el 2,3% tenía antecedente de fractura en radio distal, el 2,8% en cuello femoral y el 1,4% había tenido fractura de diáfisis femoral. La densitometría ósea (DMO) mostró un T-score promedio de -2,90 en cuello femoral, -3,02 en cadera total, -3,03 en columna lumbar y-3,42 en radio 33%. En los 602 pacientes que contaban con DMO de control se vio una ganancia de la DMO promedio en todas las regiones evaluadas. Conclusiones: El presente estudio permitió caracterizar a pacientes con diagnóstico de osteoporosis en 2 ciudades de Colombia. Las 2 localizaciones más reportadas para el diagnóstico de osteoporosis fueron columna lumbar y cuello femoral; adicionalmente, se observó una ganancia de la DMO promedio.

Lesiones musculoesqueléticas en cuidadores adultos mayores / Musculoskeletal injuries in elderly caregivers

Introducción: los escasos estudios sobre la salud de los cuidadores no profesionales se han enfocado más en las repercusiones del cuidado en su salud mental que en el estudio de lesiones musculoesqueléticas (LME), no obstante que el cuidado puede provocar el desarrollo de LME por las características personales del cuidador o debidas al medio que los rodea. Objetivo: identificar los factores asociados a LME en cuidadores adultos mayores en un hospital de segundo nivel en México y conocer su prevalencia. Material y métodos: estudio analítico observacional; se aplicó un cuestionario a 283 cuidadores adultos mayores y sus dependientes. El instrumento incluyó 62 variables relacionadas con los factores ambientales, inherentes al cuidado, personales y el sitio de lesión musculoesquelética. El análisis estadístico fue de tipo descriptivo y analítico (modelo multivariado). Resultados: la prevalencia de LME en cuidadores adultos mayores fue de 34.6%. Se encontraron como principales factores asociados ser del sexo femenino, tener alguna comorbilidad, duración del cuidado superior a 13 horas diarias por más de 13 meses, un área física reducida al brindar cui- dados y el aislamiento social; tales factores incrementaron entre 1.9 y 12 el riesgo de sufrir alguna lesión. Las LME se produjeron principalmente en el nivel lumbar de la columna vertebral. Conclusiones: este es el primer reporte en México que identifica tanto la prevalencia de LME en cuidadores adultos mayores como los factores asociados a ellas.

Background: The scarce studies regarding the non-professional caregivers health have focused more on the repercussions of care on their mental health than on the study of musculoskeletal injuries (MSI), despite the fact that care can cause the development of MSI, due to the personal characteristics of the caregiver or the environment that surrounds them. Objective: To identify the factors associated with MSI in elderly caregivers in a second-level hospital in Mexico and to know its prevalence. Material and methods: Analytical observational study; a questionnaire was administered to 283 elderly caregivers and their dependents. The survey included 62 variables related to environmental factors, factors inherent to care, and personal factors, in addition to the site of MSI; statistical analysis was descriptive and analytical (multivariate model). Results: Prevalence of MSI in older adult caregivers was 34.6%. Main factors associated were being female, having some comorbidity, duration of care greater than 13 hours a day for more than 13 months, a physical area reduced to provide care and social isolation. These factors increased between 1.9 and 12 the risk of suffering an MSI. Musculoskeletal injuries occurred mainly at the lumbar level of the spine. Conclusions: This is the first report in Mexico that identifies the prevalence of MSI in older adult caregivers and the factors associated with them.

Valoración del trabajo, exigencias y daños a la salud en académicos universitarios argentinos / Assessment of jobs, job demands and health damage in Argentine university

El objetivo de este estudio fue analizar la relación que hay entre la manera en que los académicos de la Universidad Nacional de Mar del Plata perciben el contenido del trabajo, las exigencias que demandan las actividades que deben realizar y las consecuencias de éstas sobre su salud física y mental. Se realizó un estudio transversal y observacional, con una muestra aleatoria de 151 profesores de 9 unidades académicas de la Universidad de Mar del Plata, en Argentina. Se utilizó una encuesta de tipo epidemiológico para recabar información demográfica, condiciones y valoración del trabajo, exigencias y daños a la salud. Los datos se analizaron con el programa estadístico Jump statistical program, versión 9, y se controló edad, género y antigüedad; estableciendo el nivel de significancia en p<0.05 y un intervalo de confianza del 95%.La percepción sobre el trabajo es muy satisfactoria y las exigencias más importantes fueron realizar trabajo pendiente en horas o días de descanso (79%), cubrir cursos, clases, artículos y conferencias (75%), permanecer sentado la mayor parte del tiempo (65%) y realizar tareas minuciosas (64%). Se identificó que casi la mitad de la población sufre de fatiga (46%) y trastornos musculoesqueléticos (45%), mientras que alrededor del 40% padece estrés, trastornos del sueño, cefalea, disfonía y ansiedad(AU)

The objective of this study was to evaluate how academic staff at the Mar del Plata National University in Argentina perceive the content, demands and activities of their jobs, and the consequences on their physical and mental health. A cross-sectional, observational study was carried out on a random sample of 151 professors from 9 academic units at this university. An epidemiological survey was used to collect self- reported information on demographics, job characteristics and demands and adverse health effects. The data were analyzed with the Jump™ Version 9 statistical package, controlling for age, gender and seniority. The significance level was set at p < 0.05, and 95% confidence intervals were calculated. Overall, respondents were very satisfied with their jobs. The most common job demands were working in off hours or off days, (79%), teaching courses and classes, writing articles and attending talks (75%), remaining seated most of the time (65%) and carrying out detailed tasks (64%). Almost half of the respondents reported suffering from fatigue (46%) and musculoskeletal disorders (45%), while around 40% suffered from stress, sleep disorders, headaches, dysphonia or anxiety(AU)

Evaluación del riesgo ergonómico por posturas forzadas en fisioterapeutas / Evaluation of ergonomic risk due to forced postures in physiotherapists

INTRODUCCIÓN. Los trastornos músculo esqueléticos son problemas de salud en el trabajo y causa de ausentismo laboral a nivel mundial, por lo que la valoración de los factores de riesgo laboral es necesaria para lograr prevención. OBJETIVO. Evaluar el nivel de riesgo ergonómico por posturas forzadas en los fisioterapeutas. MATERIALES Y MÉTODOS. Estudio descriptivo transversal. Población de 35 y muestra de 31 fisioterapeutas del Área de Medicina Física y Rehabilitación del Hospital de Especialidades Carlos Andrade Marín, agosto de 2020. Se aplicó el cuestionario nór-dico para conocer la percepción de la sintomatología osteomuscular; una lista de verificación rápida de condiciones de riesgo (ISO TR 12295); y, para medir el nivel de riesgo de posturas forzadas se aplicó los métodos OWAS REBA. RESULTADOS. El 96,77% (30; 31) tuvo sintomatología osteomuscular en los últimos 12 meses. Las zonas corporales con mayor afectación fueron: cuello 77,42% (24; 31), espalda alta 64,52% (20; 31), y espalda baja 58,06% (18; 31). REBA mujer: puntaje de 11; nivel de acción 4, riesgo muy alto; y, hombre: nivel de acción 3, riesgo alto. OWAS mujer: nivel 3; y, hombre: nivel 2. CONCLUSIÓN. Se evaluó el nivel de riesgo ergonómico por posturas forzadas en los fisioterapeutas. Existieron factores predisponentes para el desarrollo de trastornos músculo esqueléticos que han repercutido en el normal desarrollo de sus actividades. Las metodologías REBA y OCRA, evidenciaron que las actividades laborales presentaron un nivel de riesgo alto a muy alto, por lo que es necesaria la actuación en el mejoramiento del puesto de trabajo.

INTRODUCTION. Musculoskeletal disorders are occupational health problems and a cause of absenteeism worldwide, so occupational risk assessment is necessary to achieve prevention. OBJECTIVE. To evaluate the level of ergonomic risk due to forced postures in physical therapists. MATERIALS AND METHODS. Cross-sectional descriptive study. Population of 35 and sample of 31 physical therapists of the Phy-sical Medicine and Rehabilitation Area of the Carlos Andrade Marín Specialties Hos-pital, august 2020. The nordic questionnaire was applied to know the perception of musculoskeletal symptomatology; a quick checklist of risk conditions (ISO TR 12295); and, to measure the level of risk of forced postures the OWAS REBA methods were applied. RESULTS. The 96,77% (30; 31) had musculoskeletal symptomatology in the last 12 months. The most affected body areas were: neck 77,42% (24; 31), upper back 64,52% (20; 31), and lower back 58,06% (18; 31). REBA female: score of 11; performance level 4, very high risk; and, male: performance level 3, high risk. OWAS woman: level 3; and, man: level 2. CONCLUSION. The level of ergonomic risk due to forced postures of physiotherapists was evaluated. There were predisposing factors for the development of musculoskeletal disorders that have impacted on the normal development of their activities. The REBA and OCRA methodologies showed that the work activities presented a high to very high level of risk, which is why it is necessary to revise the activities assigned to this job position.

Prevalence and factors associated with locomotive syndrome in community-dwelling older adults / Prevalencia y factores asociados al síndrome locomotor en adultos mayores de la comunidad / Prevalência e fatores associados à síndrome locomotora em idosos comunitários

ABSTRACT Objective: to analyze prevalence and the factors associated with locomotive syndrome in community-dwelling older adults. Method: a cross-sectional study, developed in a municipal center for the care of older adults in Teresina, Piauí, Brazil. The sample was for convenience and comprised 204 older adults aged 60 years or more, of both genders and with preserved cognitive capacity, according to parameters of the Mini Mental State Examination. Data collection occurred from March to November 2018, by applying a form for sociodemographic, clinical and falls occurrence characterization and the 25-item Geriatric Locomotive Function Scale. To measure the strength of the associations between the variables, odds ratios and 95% confidence intervals were adopted. The statistical significance level was set at 5% for the analyses. Results: the prevalence of locomotive syndrome found was 37.2%. The factors associated with the presence of locomotive syndrome were individual monthly income (p=0.005); existence of one of the following comorbidities: systemic arterial hypertension (p=0.039), osteoporosis (p=0.016), arthrosis (p<0.001) or obesity (p=0.014); and history of hospitalization in the last year (p=0.007). Conclusion: the prevalence of locomotive syndrome found in this study was low and presented higher levels in older adults, with an individual monthly income of two to three minimum wages; who reported having hypertension, osteoporosis, arthrosis or obesity; and with a history of hospitalization in the last year. The health condition investigated showed to be related to aging, with significant repercussions on functionality.

RESUMEN Objetivo: analizar la prevalencia y los factores asociados al síndrome locomotor en adultos mayores de la comunidad. Método: estudio de tipo transversal, desarrollado en un centro de atención para adultos mayores de Teresina, Piauí, Brasil. La muestra fue por conveniencia y estuvo compuesta por 204 adultos mayores de 60 o más años de edad, de ambos sexos y con capacidad cognitiva preservada, según parámetros del Mini Examen de Estado Mental. Los datos se recolectaron entre marzo y noviembre de 2018 aplicando un formulario para la caracterización sociodemográfica, clínica y de caídas y la Escala Geriátrica de la Función Locomotora de 25 ítems. Para medir la fuerza de las asociaciones entre las variables, se adoptaron odds ratios e intervalos de confianza del 95%. El nivel de significancia estadística se estableció en 5% para los análisis. Resultados: la prevalencia del síndrome locomotor fue del 37,2%. Los factores asociados a la presencia del síndrome locomotor fueron los siguientes: ingreso mensual individual (p=0,005); presencia de una de las comorbilidades: hipertensión arterial sistémica (p=0,039), osteoporosis (p=0,016), artrosis (p<0,001) u obesidad (p=0,014); y antecedentes de internación en el último año (p=0,007). Conclusión: la prevalencia del síndrome locomotor que se encontró en este estudio fue baja y demostró ser superior en adultos mayores, con ingresos mensuales individuales de de dos a tres salarios mínimos; que indicaron sufrir hipertensión, osteoporosis, artrosis u obesidad; y con antecedentes de internación en el último año. La condición de salud investigada demostró estar relacionada con el envejecimiento, con repercusiones significativas sobre la funcionalidad.

RESUMO Objetivo: analisar a prevalência e os fatores associados à síndrome locomotora em idosos comunitários. Método: estudo do tipo transversal, desenvolvido em núcleo de atenção ao idoso, em Teresina, Piauí, Brasil. A amostra foi por conveniência e constituída por 204 idosos com idade igual ou superior a 60 anos, de ambos os sexos, com capacidade cognitiva preservada, segundo parâmetros do Mini Exame do Estado Mental. A coleta de dados ocorreu de março a novembro de 2018, por meio da aplicação de um formulário para caracterização sociodemográfica, clínica e de ocorrência de quedas e da Escala Geriátrica da Função Locomotora de 25 itens. Para aferição da força das associações entre as variáveis, adotaram-se razão de chances e intervalos de confiança de 95%. Nível de significância estatística estabelecido de 5% para as análises. Resultados: a prevalência da síndrome locomotora encontrada foi de 37,2%. Os fatores associados à presença da síndrome locomotora foram renda mensal individual (p=0,005); existência de uma das comorbidades: hipertensão arterial sistêmica (p=0,039), osteoporose (p=0,016), artrose (p<0,001) ou obesidade (p=0,014); e histórico de hospitalização, no último ano (p=0,007). Conclusão: a prevalência da síndrome locomotora encontrada no presente estudo foi baixa e apresentou-se maior em idosos, com renda mensal individual de dois a três salários mínimos; que referiram ter hipertensão, osteoporose, artrose ou obesidade; e com histórico de hospitalização, no último ano. A condição de saúde investigada se mostrou relacionada ao envelhecimento, com repercussões significativas sobre a funcionalidade.

Factors associated with musculoskeletal symptoms in professionals working in sitting position / Fatores associados a sintomas osteomusculares em profissionais que trabalham sentados

ABSTRACT OBJECTIVE To estimate the prevalence of musculoskeletal symptoms and analyze their associated factors in professionals from administrative sectors working predominantly in sitting position. METHODS This is a cross-sectional study with data obtained from 451 workers from a federal public institution in Southern Brazil. The dependent variable was the number of musculoskeletal symptoms in the prior 12 months, measured using the Nordic Musculoskeletal Questionnaire. In the analyses, 19 independent variables were investigated, divided into four categories: sociodemographic, behavioral, occupational and health characteristics. Univariate analysis and multiple Poisson regression with robust variance were performed. The independent variables were inserted into blocks with stepwise backward criterion, considering the value for Wald statistics equal to 0.20. The effect measures were expressed in a relative increase (RI) in the mean value, and the data were analyzed for a 5% significance level. RESULTS The estimated prevalence of musculoskeletal symptoms in the prior 12 months was 90% (confidence interval - 95%CI 87-93). In the final model of regression analysis, the variables female gender (RI = 14.75%), low (RI = 100.02%) and moderate (RI = 64.06%) work ability index, use of medications (RI = 48.06%) and waist circumference at risk (RI = 15.59%) had a significant association with the increase in the mean number of symptoms; schooling with technical education acted as a protective factor, reducing the mean by 36.46%. CONCLUSIONS The high prevalence of musculoskeletal symptoms found and the associated factors indicate the need to propose specific actions and care for this population, such as immediate treatment of symptoms and changes in the organization and work environment, to achieve balance and harmony in the demands of prolonged sitting work and avoid its impact effect of this condition on public health.

RESUMO OBJETIVOS Estimar a prevalência de sintomas osteomusculares e analisar os fatores a eles associados em profissionais de setores administrativos que trabalham predominantemente na postura sentada. MÉTODOS Trata-se de estudo transversal com dados obtidos de 451 trabalhadores de instituição pública federal na região Sul do país. A variável dependente foi o número de sintomas osteomusculares nos últimos 12 meses, aferido utilizando-se o Questionário Nórdico de Sintomas Osteomusculares. Foram investigadas 19 variáveis independentes, divididas em quatro categorias: características sociodemográficas, comportamentais, ocupacionais e de saúde. Foi realizada análise univariada e, na sequência, regressão múltipla de Poisson com variância robusta. As variáveis independentes foram inseridas em blocos com critério backward stepwise, considerando o valor para estatística de Wald igual a 0,20. As medidas de efeito foram expressas em aumento relativo (AR) no valor médio, sendo os dados analisados para um nível de significância de 5%. RESULTADOS A prevalência estimada de sintomas osteomusculares nos últimos 12 meses foi de 90% (intervalo de confiança - IC95% 87-93). No modelo final da análise de regressão, as variáveis sexo feminino (AR = 14,75%), índice de capacidade para o trabalho baixo (AR = 100,02%) e moderado (AR = 64,06%), uso de medicamentos (AR = 48,06%) e circunferência da cintura em risco (AR = 15,59%) tiveram associação significativa com o aumento da média de sintomas; já a escolaridade com ensino técnico atuou como fator de proteção, reduzindo a média em 36,46%. CONCLUSÕES A alta prevalência de sintomas osteomusculares encontrada e os fatores associados indicam a necessidade de propor ações e cuidados específicos para essa população, como tratamento imediato dos sintomas e mudanças na organização e no ambiente laboral, a fim de alcançar equilíbrio e harmonia nas exigências do trabalho sentado prolongado e evitar o impacto dessa condição na saúde pública.

Fatores associados com os distúrbios musculoesqueléticos em pescadoras artesanais/marisqueiras em Saubara, Bahia, Brasil / Factors associated with musculoskeletal disorders in artisanal fisherwomen/shellfish gatherers in Saubara, Bahia, Brazil

Resumo O presente artigo tem como objetivo identificar os fatores associados com os distúrbios musculoesqueléticos (DME) em pescoço/ombro e membros superiores distais em pescadoras artesanais/marisqueiras em Saubara, Bahia, Brasil. Trata-se de um estudo de corte transversal realizado com 209 pescadoras artesanais/marisqueiras. Foram utilizados para este estudo a versão brasileira do questionário de conteúdo do trabalho e do questionário nórdico e um questionário das demandas físicas para o trabalho. As análises multivariadas foram feitas de acordo com os principais fatores de risco para DME. Algumas demandas físicas agrupadas, nas etapas da coleta dos mariscos e na cata, se associaram, respectivamente, com DME em pescoço ou ombro [Razão de Prevalência - RP: 1,28 (IC95%: 1,09-1,49)] e DME em membros superiores distais [RP: 1,38 (IC95%: 1,05-1,83)], no modelo final ajustado. As RP ajustadas para DME em membros superiores distais foram de 1,26 (IC95%: 1,07-1,47), de acordo com as horas diárias dedicadas ao trabalho como marisqueira, e 0,74 (IC95%: 0,57-0,96) de acordo com o desenvolvimento de outro trabalho atualmente. O modo em que é desenvolvido o trabalho da marisqueira é importante para ocorrência dos DME.

Abstract This article aims to identify the factors associated with musculoskeletal disorders (MSDs) in the neck/shoulder and distal upper limb in artisanal fisher/shellfish gatherers in Saubara, Bahia, Brazil. This cross-sectional epidemiological study was conducted with shellfish gatherers. The Brazilian version of the Job Content Questionnaire (JCQ), the Nordic Musculoskeletal Questionnaire (NMQ), and a questionnaire containing physical demands adapted to the labour of shellfish gatherers were used in this study. Factor analysis was performed to aggregate the physical demands. Multivariate analyses were performed according to the risk factors for MSDs in the neck or shoulder and MSDs in the distal upper limb. For MSDs in the neck or shoulders, a prevalence ratio (PR) of 1.28 (95% confidence interval [95% CI]: 1.09-1.49) was found, according to the aggregate physical demands. For MSDs in the distal upper limb, the PRs were as follows: 1.26 (95% CI: 1.07-1.47) according to the daily hours devoted to work as shellfish gatherers, 0.74 (95% CI: 0.57-0.96) according to the development of other current work and 1.38 (95% CI: 1.05-1.83) according to the aggregate physical demands. The activities performed by shellfish gatherers contribute to the occurrence of MSDs.

Trastornos musculoesqueléticos del miembro superior en el Hospital Militar de Matanzas / Muscle skeletal dysfunctions of superior member in the Military Hospital of Matanzas

RESUMEN Introducción: Los trastornos musculoesqueléticos constituyen uno de los problemas más comunes relacionados con las enfermedades en el trabajo. Objetivo: caracterizar algunas variables clínicas y epidemiológicas de los pacientes con trastornos musculoesqueléticos del miembro superior atendidos en el Servicio de Rehabilitación del Hospital Militar de Matanzas. Materiales y métodos: se desarrolló un estudio descriptivo, durante el primer semestre del año 2017. Las variables estudiadas fueron: sexo, actividad laboral desarrollada, factores de riesgos ergonómicos, trastorno musculoesquelético diagnosticado, antecedentes de crisis similares anteriores y tiempo de incapacidad laboral relacionado con estas afecciones durante los últimos 12 meses. Resultados: el 59,4 % de los pacientes correspondieron al sexo femenino, la actividad laboral más afectada fue la de camareras y auxiliares de limpieza (18,9 %), la repetitividad estuvo presente como factor de riesgo en el 64,5 % de los pacientes y la epicondilitis afectó al 38,5 % de los mismos. El 60,4 % de los pacientes habían presentado crisis anteriores y el 72,9 % de ellos presentó incapacidad laboral. Conclusiones: predominó el sexo femenino, las actividades laborales más afectadas fueron las de limpieza, la repetitividad fue el principal factor de riesgo y la epicondilitis fue el diagnóstico que predominó. La mayor parte de los pacientes habían presentado crisis similares anteriores y períodos de incapacidad laboral relacionados con el trastorno musculoesquelético (AU).

ABSTRACT Introduction: The muscle skeletal dysfunctions constitute one of the more common problems related with the illnesses in the work. Objective: To characterize several clinical and epidemiologic variables of the patients with muscle skeletal dysfunctions of the superior member assisted in the Military Hospital of Matanzas. Materials and methods: A descriptive study was developed during the first semester of 2017 year. The studied variables were: developed labor activity, factors of ergonomic risks, muscle skeletal dysfunctions diagnosed, antecedents of previous similar crisis and time of labor inability related with these affections in the last 12 months. Results: 59,4 % of the patients corresponded to the female sex, the labor activity more affected was waitresses and auxiliary of cleaning (18,9 %), the repetitive were present as factor of risk in 64,5 % of the patients and the epicondylitis affected to 38,5 % of them. Conclusions: Predominated the female sex, the labor activities more affected were the cleaning, the repetitive was the main factor of risk and the epicondylitis was the diagnose that prevailed. Most of the patients had presented previous similar crisis and periods of labor inability related with muscle skeletal dysfunction (AU).

Musculoskeletal pain and musculoskeletal syndromes in adolescents are related to electronic devices / Dor musculoesquelética e síndromes musculoesqueléticas em adolescentes relacionadas a dispositivos eletrônicos

Abstract Objective: To evaluate television and simultaneous electronic devices use in adolescents with musculoskeletal pain and musculoskeletal pain syndromes. Methods: A cross-sectional study was performed in 299 healthy adolescents of a private school. All students completed a self-administered questionnaire, including: demographic data, physical activities, musculoskeletal pain symptoms, and use of simultaneous television/electronic devices (computer, internet, electronic games, and cell phones). Seven musculoskeletal pain syndromes were also evaluated: juvenile fibromyalgia, benign joint hypermobility syndrome, myofascial syndrome, tendinitis, bursitis, epicondylitis, and complex regional pain syndrome. Results: Inter-rater agreement between pretest and retest was 0.83. Musculoskeletal pain and musculoskeletal pain syndrome were found in 183/299 (61%) and 60/183 (33%), respectively. The median age (15 [10-18] vs. 14 [10-18] years, p = 0.032) and years of education (10 [5-12] vs. 9 [5-12] years, p = 0.011) were significantly higher in adolescents with musculoskeletal pain when compared with those without this condition. The frequencies of female gender (59% vs. 47%, p = 0.019), cell phone use (93% vs. 81%, p = 0.003), and simultaneous use of at least two electronic devices (80% vs. 67%, p = 0.011) were significantly higher in the former group. Further comparisons between adolescents with and without musculoskeletal pain syndromes revealed that the frequency of female gender was significantly higher in the former group (75% vs. 25%, p = 0.002), and with a significantly reduced median of weekends/holidays electronic games use (1.5 [0-10] vs. 3 [0-17] h/day, p = 0.006). Conclusions: A high prevalence of musculoskeletal pain/syndromes was observed in female adolescents. Musculoskeletal pain was mostly reported at a median age of 15 years, and students used at least two electronic devices. Reduced use of electronic games was associated with musculoskeletal pain syndromes.

Resumo Objetivo: Avaliar o uso de televisão e dispositivos eletrônicos em adolescentes com dor e síndromes musculoesqueléticas. Métodos: Foi feito um estudo transversal com 299 adolescentes saudáveis de uma escola particular. Todos os alunos responderam a um questionário autoaplicável, que incluiu perguntas sobre: dados demográficos, prática de atividade física, sintomas de dor musculoesquelética e o uso de televisão/dispositivos eletrônicos (computador, internet, jogos eletrônicos e celular). Sete síndromes musculoesqueléticas foram avaliadas: fibromialgia juvenil, síndrome de hipermobilidade articular benigna, síndrome miofascial, tendinite, bursite, epicondilite e síndrome de dor regional complexa. Resultados: A concordância entre o pré-teste e reteste foi de 0,83. Dor musculoesquelética e síndromes musculoesqueléticas foram encontradas em 183/299 (61%) e 60/183 (33%), respectivamente. As medianas de idade [15 (10-18) versus 14 (10-18) anos, p = 0,032] e de anos de escolaridade [10 (5-12) vs. 9 (5-12) anos, p = 0,010] foram significantemente maiores em adolescentes com dor musculoesquelética em comparação com aqueles sem essa condição. As frequências do sexo feminino (59% versus 47% p = 0,019), uso do telefone celular (93% contra 81%, p = 0,003) e do uso simultâneo de pelo menos dois dispositivos eletrônicos (80% vs. 67%, p = 0,011) foram significantemente maiores no grupo de adolescentes com dor musculoesquelética. Comparações adicionais entre os adolescentes com e sem síndromes musculoesqueléticas revelaram que a frequência do sexo feminino foi significantemente maior no primeiro grupo (75% versus 25%, p = 0,002) e com mediana significantemente reduzida de horas de jogos eletrônicos nos fins de semana e feriados [1,5 (0-10) vs. 3 (0-17) horas/dia, p = 0,006]. Conclusões: Uma alta prevalência de dor/síndromes musculoesqueléticas foi observada em adolescentes do sexo feminino. A dor musculoesquelética foi predominantemente relatada entre alunos com mediana de idade de 15 anos e que usavam pelo menos dois dispositivos eletrônicos simultaneamente. O uso reduzido de jogos eletrônicos foi associado à presença de síndromes musculoesqueléticas.

Evaluación ergonómica del puesto de trabajo ayudante de mesa de baja presión en una empresa cervecera / Workstation ergonomic evaluation of alow pressure table assistant position in a brewery

Se realizó un estudio descriptivo, con enfoque ergonómico, para determinar riesgos de lesiones músculo-esqueléticas, en el puesto de trabajo "Ayudante de mesa de baja presión", en una empresa cervecera en la ciudad de Cagua, Venezuela. Diez hombres conformaron la muestra en la fase I, y dos en la fase II: bachilleres, sedentarios, 30,1 años de edad promedio, laborando en turnos rotativos de lunes a viernes, en las tareas: encajonar, quitar chapas, posicionar, arrumar, traslado y paletizar. Mediante entrevista personal y colectiva (utilizando la guía DEPARIS) se conocieron sus características socio-demográficas y opiniones respecto a problemas de salud, vinculados al puesto de trabajo. Los riesgos de lesiones músculo-esqueléticas fueron identificados con el método MODSI y Ecuación de NIOSH. Dicha evaluación indicó que en las tareas "encajonar, "quitar chapas", el riesgo es de nivel "medio", y en "posicionar", "arrumar", "traslado", y "paletizar", el riesgo es alto. En situaciones de "posicionar" y "traslado", fue considerado "muy alto", debido a factores como: bipedestación prolongada, movimientos de torsión de tronco, extensión de hombros, codos y brazos, lateralización de muñecas, flexión de espalda y cuello, y relativa fuerza. La organización del trabajo amerita cambios: aplicar un plan para disminuir las botellas rechazadas, diseñar herramientas de mano para destapar las botellas, instalar una silla para la alternabilidad de posturas, junto a un plan preventivo de trastornos músculo-esqueléticos, pausas activas y accidentes de trabajo, dotar de equipos de protección personal, ampliar los espacios de trabajo e incorporar ayuda mecánica adecuada a las características de las tareas y la necesidad de los trabajadores(AU)

We carried out a two-phase descriptive ergonomic evaluation of the low pressure table assistant job position in a brewery in Cagua, Venezuela to determine the risk of musculoskeletal injuries. There were 10 single men in phase I and two men in phase II, with an average age of30.1 years, working in rotating shifts from Monday through Friday. Tasks consisted of boxing, removing plates, positioning, cleaning up, transfers and palletizing. We used individual and group interviews (DEPARIS guide) to collect information on sociodemographic characteristics and opinions regarding job-related health issues. Risk of musculoskeletal injury was measured using the MODSI method and NIOSH Equation. This evaluation identified a medium risk for boxing and removing plates; it was high for positioning, arranging, moving, and palletizing. For tasks involving positioning and transfers, the risk was very high due to prolonged standing, trunk twisting, extension of the shoulder, elbow and forearm, lateralization of the wrists, back and neck flexion, and relative force. We also recommended some changes in how the work was organized. Among these implementing a plan to reduce rejected bottles, designing hand tools to open bottles, installing a multi-position chair to allow changes in posture, developing a preventive plan for musculoskeletal disorders, work breaks and accident prevention, providing personal protective equipment, expanding work spaces and incorporating mechanical assist devices appropriate to the characteristics of the tasks and worker needs(AU)

Absenteísmo por distúrbios musculoesqueléticos em trabalhadores do Brasil: milhares de dias de trabalho perdidos / Absenteeism due to musculoskeletal disorders in Brazilian workers: thousands days missed at work

RESUMO: Objetivo: Descrever e analisar o absenteísmo dos trabalhadores do Brasil notificados com distúrbios musculoesqueléticos, do período de 2007 a 2012. Métodos: Estudo quantitativo, transversal e descritivo, com dados retrospectivos e secundários. Os registros foram do Sistema de Informação de Agravos de Notificação, que notifica trabalhadores em regime de previdência, bem como os informais. O período do estudo foi de seis anos. As variáveis foram: sociodemográficas, organizacionais do trabalho e específicas do agravo. Resultados: Foram aproximadamente 5 milhões de dias perdidos de trabalho, de 18.611 trabalhadores afastados e notificados com o agravo. Os grupos que mais se destacaram na análise foram os analfabetos, na faixa etária dos 50 aos 59 anos, com carga horária diária de trabalho acima de 6 horas, do grande grupo ocupacional 4, os CID-10 M50 e M51 e os trabalhadores com transtornos mentais. Conclusões: Elevado absenteísmo entre os trabalhadores com distúrbios musculoesqueléticos, analfabetos, idade dos 50 aos 59 anos, trabalhadores de serviços administrativos, CID-10 M51 e trabalhadores com transtornos mentais. Há necessidade de traçar políticas públicas que contemplem o absenteísmo causado pelo agravo, a fim de reduzir a morbidade, bem como os prejuízos socioeconômicos.

ABSTRACT: Objective: To describe and analyze the absenteeism of Brazilian workers notified with musculoskeletal disorders, from 2007 to 2012. Methods: This is a quantitative, cross-sectional and descriptive study, including retrospective and secondary data. The records came from the Information System of Notifiable Diseases, which notifies workers on a social security system, as well as informal workers. The study lasted for six years. We analyzed sociodemographic, work organization and injury variables. Results: There were approximately 5 million working days lost for 18,611 workers who were notified and removed from the position. The groups that stood out in the analysis were the illiterate people, in the age group of 50 to 59 years, with daily working hours higher than 6 hours, from the great occupational group 4, the ICD-10 M50 and M51, and workers with mental disorders. Conclusions: High absenteeism among workers with musculoskeletal disorders, illiterate, aged from 50 to 59 years, administrative service workers, ICD-10 M51 and workers with mental disorders. It is necessary to outline public policies that contemplate the absenteeism caused by the disease, in order to reduce morbidity, as well as the socioeconomic losses.

Artisanal fisherwomen/shellfish gatherers: analyzing the impact of upper limb functioning and disability on health-related quality of life / Pescadoras artesanais/marisqueiras: análise do impacto da funcionalidade e incapacidade de membros superiores sobre a qualidade de vida relacionada com a saúde

Abstract The aim is to analyze upper limb functioning and disability, and its association with health-related quality of life among artisanal fisherwomen from Bahia, Brazil. Cross-sectional epidemiological study was conducted with a sample of 209 fisherwomen. Structured questionnaires were used for socio-demographic and comorbidity information, as well as the instruments Disabilities of the Arm, Shoulder and Hand (DASH) and Short-Form Healthy Survey (SF-36) respectively, to evaluate the upper limbs and health-related quality of life. The results demonstrated that the presence of musculoskeletal disorders in the upper limbs directly affects the values of the DASH instrument and the SF-36v01 questionnaire scores, while also generating a negative correlation between the DASH and SF-36v01. The varying functioning abilities, pain and social aspects negatively affect upper limb function, and the daily activities and work of fisherwomen. The presence of chronic disease and the absence of intervention and rehabilitation for these professionals, that could produces, in a long-term, cases of disability.

Resumo O objetivo foi analisar a incapacidade e a funcionalidade de membros superiores e verificar sua associação com a qualidade de vida relacionada com a saúde de pescadoras artesanais da Bahia, Brasil. Estudo epidemiológico, de corte transversal, envolvendo uma amostra de 209 pescadoras artesanais. Foram utilizados questionários estruturados para informações sociodemográficas e comorbidades e os instrumentos Disabilities of the Arm, Shoulder and Hand (DASH) e Medical Outcomes Study 36-Item Short-Form Healthy Survey (SF-36), para, respectivamente, avaliação dos membros superiores e qualidade de vida relacionada com a saúde. Os resultados encontrados demonstram que a presença de distúrbios musculoesqueléticos (DME) em membros superiores afeta diretamente os valores do instrumento DASH e os escores do SF-36v01, bem como a correlação negativa encontrada entre o DASH e os domínios do SF-36v01. As variáveis capacidade funcional, dor e aspectos sociais afetam negativamente a funcionalidade de membros superiores e as atividades do cotidiano e do trabalho de pescadoras artesanais. A presença de doença crônica e a ausência de intervenção e reabilitação desses profissionais geram, a longo prazo, casos de incapacidade.

Factor associated with self-reported work-related musculoskeletal disorders in Brazilian adults / Fatores associados a distúrbios osteomusculares relacionados ao trabalho autorreferidos em adultos brasileiros

ABSTRACT OBJECTIVE To describe the prevalence of work-related musculoskeletal disorder (WMSD) and analyze the factors associated with this outcome in the Brazilian population. METHODS In this cross-sectional, population-based study, we use data from the National Survey on Health (PNS) of 2013. The sample was composed of 60,202 Brazilians aged 18 years or older. The outcome variable was the occurrence of self-reported WMSD. Sociodemographic and occupational characteristics, personal resources, and health conditions were investigated as explanatory variables. Analyses were performed with the software Stata 12.0 and considered the weighting imposed by the sampling design of the study. Then, univariate and multivariate binary logistic models were carried out, considering a significance level of 5%. RESULTS The results obtained indicated that the prevalence of WMSD in the Brazilian population was of 2.5%, ranging from 0.2% (Acre) to 4.2% (Santa Catarina). The factors associated with a greater chance of occurrence of WMSD were: female sex (OR = 2.33; 95%CI 1.72–3.15); be temporarily away from work (OR = 2.44; 95%CI 1.41–4.23); be exposed to noise at the workplace (OR = 2.16; 95%CI 1.68–2.77); seniority equal to or greater than 4.5 years at the current job (OR = 1.37; 95%CI 1.09–1.72); participate in volunteer work (OR = 1.65; 95%CI 1.25–2.17); report medical diagnosis of arthritis or rheumatism (OR = 2.40; 95%CI 1.68–3.44); and depression (OR = 2.48; 95%CI 1.86–3.31). On the other hand, factors associated with less chance of WMSD were: not having a partner (OR = 0.73; 95%CI 0.37–0.71) and working in an open environment (OR = 0.51; 95%CI 0.37–0.71). CONCLUSIONS The associated factors and the prevalence found indicate regional and gender differences. Special attention to comorbidities and environmental noise monitoring would benefit the health of workers in the Country.

RESUMO OBJETIVO Descrever a prevalência de distúrbio osteomuscular relacionado ao trabalho (Dort) e analisar os fatores associados com esse desfecho na população brasileira. MÉTODOS Neste estudo transversal, de base populacional, utilizamos dados da Pesquisa Nacional de Saúde (PNS) de 2013. A amostra foi composta por 60.202 brasileiros com 18 anos ou mais de idade. A variável desfecho foi a ocorrência de Dort autorreferida. Como variáveis explicativas, foram investigadas características sociodemográficas, ocupacionais, recursos pessoais e condições de saúde. As análises foram realizadas com o software Stata 12.0 e levaram em consideração as ponderações impostas pelo delineamento amostral do estudo. Foi realizado, então, um modelo logístico binário uni e multivariado, considerando o nível de significância de 5%. RESULTADOS Os resultados obtidos indicaram que a prevalência de Dort na população brasileira foi de 2,5%, variando de 0,2% (Acre) a 4,2% (Santa Catarina). Os fatores associados à maior chance de ocorrência de Dort foram: sexo feminino (OR = 2,33; IC95% 1,72–3,15); estar afastado temporariamente do trabalho (OR = 2,44; IC95% 1,41–4,23); estar exposto a ruído no local de trabalho (OR = 2,16; IC95% 1,68–2,77); antiguidade igual ou superior a 4,5 anos no trabalho atual (OR = 1,37; IC95% 1,09–1,72); participar de trabalho voluntário (OR = 1,65; IC95% 1,25–2,17); relatar diagnóstico médico de artrite ou reumatismo (OR = 2,40; IC95% 1,68–3,44) e de depressão (OR = 2,48; IC95% 1,86–3,31). Por outro lado, foram associados à menor chance de diagnóstico de Dort: não ter parceiro (OR = 0,73; IC95% 0,37–0,71) e trabalhar em ambiente aberto (OR = 0,51; IC95% 0,37–0,71). CONCLUSÕES Os fatores associados e a prevalência encontrada indicam diferenças regionais e de gênero. Especial atenção às comorbidades e monitoramento do ruído ambiental beneficiariam a saúde dos trabalhadores no país.